Senior Database Engineer

Medblocks is building a developer-focused stack for healthcare that makes it possible for anyone to build applications that integrate directly with clinical workflows without rebuilding expensive Electronic Medical Records systems. We believe code has the potential to save more lives than doctors can by themselves.

Founded by doctors-turned-programmers, our team leverages open, vendor-neutral standards like openEHR, FHIR, SMART, and SNOMED CT to create a platform that makes healthcare data accessible, interoperable, and useful.

At Medblocks, we operate with three core values:

Trust:We trust youll get your work done without micromanagement. We dont enforce working hours or monitor your activitywe measure outcomes, not outputs.

Transparency:We believe information flow is at the heart of a healthy company. We share detailed financials and metrics with our team and maintain open communication about company direction.

Customer Value & Honesty:Were obsessively focused on delivering value to our customers and maintaining honest relationships about what our technology can and cannot do.

Were a remote-first team that values deep work, clear communication, and continuous learning. Were building technology that matters, and were looking for individuals who want their code to make a difference in healthcare.

As a Senior Data Platform Engineer at Medblocks, you will be the primary architect of our data infrastructure, designing and implementing the foundation that powers our entire healthcare platform. This is a high-ownership role where youll make critical decisions about data architecture, security, and performance that will scale with us for years to come.

Key responsibilities include:

• Architecting and implementing complex PostgreSQL database schemas that handle millions of healthcare records with sub-second query performance
• Writing and optimizing advanced PostgreSQL features including RLS (Row-Level Security) policies, stored procedures, triggers, and custom functions
• Building reliable, real-time data pipelines using CDC (Change Data Capture) and event-driven architectures to sync data across multiple systems
• Designing and implementing database performance monitoring, query optimization, and debugging strategies
• Creating data integration patterns that map between our core PostgreSQL database and external systems (data warehouses, analytics platforms, third-party APIs)
• Establishing database CI/CD practices including migration strategies, testing frameworks, and zero-downtime deployment patterns
• Mentoring team members on database best practices and reviewing critical database design decisions
• Documenting complex data models and creating technical specifications that other engineers can follow

• Deep technical curiosity:You read PostgreSQL release notes for fun and have opinions about indexing strategies
• Systems thinking:You understand how database decisions impact the entire application stack
• Ownership mentality:Youve been the person others turn to when the database is on fire at 2 AM
• Teaching ability:You can explain why denormalization might be the right choice to both junior engineers and senior architects
• Pragmatism:You know when to use triggers vs application logic, when to normalize vs denormalize

Must have:

• 5+ years of production database engineering experience, with at least 3 years focused on PostgreSQL
• Proven experience designing complex relational data models (50+ tables) that have scaled in production
• Deep PostgreSQL expertise including:
• Advanced SQL (CTEs, window functions, recursive queries)
• PL/pgSQL programming for procedures and triggers
• Performance tuning (query plans, indexing strategies, vacuum configuration)
• Security implementations (RLS, role-based access)
• Experience building data pipelines and ETL/ELT processes at scale
• Hands-on experience with data integration patterns (CDC, event streaming, batch processing)
• Strong DevOps skills including:
• Database migration tools and strategies
• CI/CD pipeline implementation
• Infrastructure as Code (Terraform, Ansible)
• Containerization and orchestration
• Experience with monitoring and debugging production database issues
• Track record of working in high-autonomy environments where you owned technical decisions

Nice to have:

• Experience with data warehouse technologies (Snowflake, BigQuery, Redshift, Apache Iceberg)
• Knowledge of event streaming platforms (Kafka, Debezium, Apache Pulsar)
• Familiarity with dbt, Apache Airflow, or similar data orchestration tools
• Experience with time-series data or audit log patterns
• Contributions to PostgreSQL extensions or database-related open source projects
• Experience with multi-tenant database architectures
• Background in regulated industries requiring data compliance

• This is not a junior or mid-level position - we need someone who can make architectural decisions independently
• This is not a traditional DBA role focused on maintenance - youll be building new systems
• This is not a pure analytics/BI role - youll be working on transactional systems that power production applications

• Competitive salary commensurate with senior engineering roles
• Flexible, remote-first work environment
• Complete autonomy to design and build our data platform
• Direct collaboration with founders on technical strategy
• Transparent company financials and metrics
• Regular opportunities to speak at conferences and write technical content
• Travel opportunities for team meet-ups and conferences
• Liberal leave policy with no micromanagement
• The chance to build the data infrastructure for healthcare from first principles